TRIBUTE to O. Carl Simonton

Obituary: Dr. O. Carl SimontonExcerpts from Getting Well AgainPaul Durbin: 6 Session Protocol for Cancer - Adapted from Simonton Model in Getting Well AgainObituary: DR. O. Carl SimontonJune 29, 1942 - June 18, 2009Dr. O. Carl Simonton, a radiation oncologist who popularized the mind-body
connection in fighting cancer and helped push the once-controversial notion into
mainstream medicine, has died. He was 66. Dr. Simonton, who founded a cancer
care clinic in Pacific Palisades on the west side of Los Angeles in the early
1980s, choked to death June 18 during a meal at his Los Angeles area home in
Agoura Hills, said his wife, Karen. Early in his medical career, Dr. Simonton
noticed that patients given the same dose of radiation for similar cancers had
different outcomes. When he looked into why, he concluded that people who had a
more positive attitude generally lived longer and had fewer side effects.
Talking openly about cancer was groundbreaking in the 1970s, as were such Dr.
Simonton techniques as meditation and mental imagery, said Julia Rowland,
director of the National Cancer Institute's Office of Cancer Survivorship. "For
an oncologist to pioneer a mind-body approach was very provocative at the time,
and yet very humane," Dr. Rowland said. "It gave people more of a sense of
control over their illness and allowed patients to think differently about their
role in the healing process."
After implementing an early psycho-social oncology program while chief of
radiation therapy at Travis Air Force Base in Fairfield, Calif., in the early
1970s, Dr. Simonton founded a cancer counseling and research center in Fort
Worth, Texas, that included emotional support as a key component. His own
research indicated that when lifestyle counseling was added to medical treatment
for patients with advanced cancer, their survival time doubled and their quality
of life improved.
A study by Stanford University and the University of California, Berkeley
researchers concluded in 1989 that women with advanced breast cancer who
received emotional counseling lived about twice as long as those who did not.
The study was independent evidence that Dr. Simonton's "whole body" approach to
battling the illness made a difference, Dr. David Siegel, a psychiatrist and
Stanford professor who wrote the study, confirmed in an e-mail to the Los
Angeles Times.
Dr. Simonton outlined his "will to live" philosophy of cancer care in
"Getting Well Again," a 1978 book written with his second wife, a
psychotherapist then known as Stephanie Matthews-Simonton, and others. It drew
on first-hand experience with patients at his Fort Worth cancer-care center. The
book was "highly praised" by officials at the National Institutes of Health and
doctors who specialized in cancer and heart problems, the Times reported in a
1981 article with the headline, "Medicine's 'Other Side' -- the Mind." Thousands
of counselors have trained in the Simonton Method, which includes teaching
patients to visualize their bodies fighting cancer cells -- and winning the war.
According to the American Cancer Society, "available scientific evidence does
not support claims that imagery can influence the development or progress of
cancer" but it can help reduce stress, depression, manage pain and ease
side-effects, in addition to creating "feelings of being in control." The use of
guided imagery is much more accepted and widely used today, especially to manage
side-effects, a development that can be traced to Dr. Simonton's research, said
Dr. Rowland of the National Cancer Institute. Differences over theory sparked
his divorce from Ms. Matthews-Simonton, who went on to establish a more
psychologically oriented clinic in Arkansas. Dr. Simonton's first marriage also
ended in divorce.
In 1984, he was seeking a professional climate that would be friendlier to
his controversial work when he founded the Simonton Cancer Counseling Center in
Pacific Palisades. The center will continue operating.
He insisted that feelings of hopelessness contribute to a hastier death.
"Most of us kill ourselves with unconscious emotional pain," he said in a 1995
interview and warned to beware of those who say there is no hope. "Label those
people as ill-informed and hazardous to your health," he said. Oscar Carl
Simonton was born in west Los Angeles on June 29, 1942. He was the youngest of
four children of a Baptist minister and his wife. Following undergraduate work
at an Arizona college, Dr. Simonton earned his medical degree from the
University of Oregon.
In his late 30s, Dr. Simonton was described as having "a penchant for
four-letter expletives and a willingness to appear on a platform in his jogging
shorts to give a speech. His wife said that remained an apt description of her
husband, who loved to crack jokes and thought nothing of accidentally wearing
tennis attire to a formal dinner.

Excerpts from Getting Well Again

Everyone participates in his or her health or illness at all times. We use the word participate to indicate the vital role you play in creating your own level of health. Most of us assume that healing is something done to us, that if we have a medical problem our responsibility is simply to get to a physician who will then heal us. That's true to a degree, but it is only part of the story. We participate in our own health through our beliefs, our feelings, and our attitude toward life, as well as in more direct ways, such as through exercise and diet. In addition, our response to medical treatment is influenced by our beliefs about the effectiveness of the treatment and by the confidence we have in the medical team. (p.3) If the difference between the patient who regains his health and the one who does not is n part a matter of attitude toward the disease and belief that he could somehow influence it, then we wondered, how could we influence patients' beliefs in that positive direction? Might we be able to apply techniques from motivational psychology to induce and enhance a "Will to live?" Beginning in 1969, we began looking at all the possibilities, exploring such diverse psychological techniques, "mind development" courses like Silva Mind Control, and Mind Dynamics, and biofeedback. (p. 5-6) From our study of biofeedback, we learned that certain techniques were enabling people to influence their own internal body processes, such as heart rate and blood pressure. An important aspect of biofeedback, called visual imagery, was also a principal; component of other techniques we had studied. The more we learned about the process, the more intrigued we became. Essentially, the visual imagery process involved a period of relaxation, during which the patient would mentally picture a desired goal or result. With the cancer patient, this would mean his attempting to visualize the cancer, the treatment destroying it and, most importantly, his body's defenses helping him recover. After discussions with two leading biofeedback researchers, Drs. Joe Kamiya and Elmer Green, of the Menninger Clinic, we decided to use visual imagery techniques with cancer patients. (p, 6) It is our central premise that an illness is not purely a physical problem but rather a problem of the whole person, that includes not only body but mind and emotions. (Durbin - in later works Dr. Simonton adds spiritual as well as physical and emotional.) We believe that emotional and mental states play a significant role both in susceptibility to disease, including cancer, and in recovery from all disease. We believe that cancer is often an indication of problems elsewhere in an individual's life, problems aggravated or compounded by a series of stresses six to eighteen months prior to the onset of cancer. The cancer patient has typically responded to these problems and stresses with a deep sense of hopelessness, or "giving up." This emotional response, we believe, in turn triggers a set of physiological responses that suppress the body's natural defenses and make it susceptible to producing abnormal cells. If the total integrated system of mind, body and emotions, which constituted system of mind, body and emotions, which constitutes the whole person, is not working in the direction of health, then purely physical interventions may not succeed. An effective treatment program, then, will deal with the total human being and not focus on the disease a alone, for that would be like trying to treat a yellow fever epidemic with sulfa alone, without also draining the ditches in which the sickness-bearing mosquitoes breed. (p. 10) Of course, duration of life after diagnosis is only one aspect of the disease. Of equal (or perhaps greater) importance is the quality of life while the patient survives. There are few existing objective measures of quality of life: however, one measure we keep in the level of daily activity maintained during the after treatment compared to the level of activity prior to diagnosis. (p. 11) While stress may predispose to illness, the significant factor still seems to be how the individual copes with it. Clearly the meaning of an event - even a stressful one - is construed differently from person to person. Loss of a job at age twenty will usually be less stressful than will loss of job at fifty. When a person is enthusiastically looking forward to retirement, eager to spend time on a number of important projects, then retirement is much less stressful than it is when it is impose by mandatory retirement rules. Some divorces are extremely bitter and shattering while others are more amiable. The same logic applies to all the other items on the stress list: since the events involve change, they will all produce some stress; but the amount of stress varies with the individual. Stress may accumulate to the point that the individual can no longer cope and consequently becomes ill. (p. 46) "The explanation, we suspect, is that the activity of coping can lower resistance to disease, particularly when one's coping techniques are faculty: when they lack relevance to the ... problem to be solved. This approach to illness is a lesson in human finitude (reminding) us that we have only so much energy, no more. If it takes too much effort with the environment, we have less to spare for preventing disease. When life is too hectic, and when coping attempts fail, illness is the unhappy results. (Holmes and Masude) (p. 46) Chronic stress frequently produces hormonal imbalances. Since hormones play a critical role in regulating body functions, these imbalances can lead to high blood pressure and eventually damage to the kidneys. The damage to the kidneys can, in turn, lead to sever hypertension (high blood pressure), which will reinforce the chemical imbalance. (p. 49)SUMMARY OF EMOTIONAL STRESS FINDINGS:(1) High levels of emotional stress increase susceptibility to illness. (2) Chronic stress results in a suppression of the immune system, which in turn creates increased susceptibility to illness - and especially to cancer. (3) Emotional stress, which suppresses the immune system, also leads to hormonal imbalances. These imbalances could increase the production of abnormal cells at precisely the time the body is lease capable of destroying them. (4) It is significant that the amount of emotional stress caused by external events depends on how the individual interprets or copes with the event. Even though researchers are able to predict illness based on the number of stressful events in people's life, a number of individuals in these studies did not get sick, even though they experienced high levels of stress. It is necessary to look at the individual's unique response to a stressful event. (p. 51) People with similar personality traits don't all develop the same illness any more than all people subjected to the same carcinogenic agents develop cancer. Many other factors play a significant role. (p. 57) Based on Dr. Elilda Evans' ( A Psychological Study of Cancer (1926) ) analysis of one hundred cancer patients, Evans concluded that many cancer patients had lost an important emotional relationship before the onset of the disease. She saw such patients as people who had invested their identity in one individual object or role (a person, a job, a home) rather than developing their own individuality. When the object or role was threatened or removed, such patients were thrown back on themselves, with few internal resources to cope. (We, too, have found the characteristic o putting others' needs before one's own in our patients.) Evans also believed that cancer was a symptom of other unresolved problems in a patient's life, and her observations have since been confirmed and elaborated on by a number of other researches.(p. 57-58) When we considered cancer a purely physical problem, we viewed patients' descriptions of their emotional states as something to be responded to with sympathy and understanding but having little to do with the course of the disease. As we learned that the "whole person" participates in the course of the disease, we began to pay very close attention to everything our patients said. (p. 63)GETTING WELL AGAIN: We have observed four psychological steps that occur in the upward spiral of recovery: (1) With the diagnosis of a life-threatening illness, the individual gains a new perspective on his or her problems. (2) The individual makes a decision to alter behavior to be a different kind of person. (p. 71) (3) Physical processes in the body respond to the feelings of hope and the renewed desire to live, creating a reinforcing cycle with the new mental state. The renewed hope and desire to live initiate physical processes that result in improved health. Since mind, body, and emotions act as a system, changes in the psychological state result in changes in the physical state. This is a continuing cycle, with an improved physical state bringing renewed hope in life and with renewed hope bringing additional physical improvement. (4) The recovered patient is "weller than well." Karl Menninger, founder of the Menninger Clinic, describes patients who have recovered from bouts with mental illness as frequently being "weller than well," meaning that the state of emotional health to which they have been restored is in fact superior to what they had considered "well" before their illness. (p. 72) We have all experienced what are called self-fulfilling prophecies - that is, because we expect something to happen, we act in ways that increase the likelihood that the expectation will be met. (Durbin - this can be good or bad, depending on the expectation.) (p. 75) The most significant finding of the study was that a positive attitude toward treatment was a better predictor of response to treatment than was the severity of the disease. That is, patients who had serious prognoses but positive attitudes did better than patients who had relatively less serious prognoses but negative attitudes. In addition, patients who began to view their treatment positively often reported reduced side effects. (p. 77)THE QUESTION OF "FALSE HOPE" : We are sometimes asked, "Aren't you giving your patients false hope." Our answer is "No," we are giving our patients reasonable hope. Our approach does not guarantee recovery. But the question of "false hope" suggest that people should never have hope if there is a good chance they will be disappointed. Such a belief provides no basis for living a full lie or for dealing with a threat to life. (p. 81) Patients who have worked hard using our approach have still died, although in many cases they have significantly outlived their prognoses - and lived a more rewarding life than they would have had they not actively participated in their treatment. Yet death appears inevitable for us all. And our program includes activities designed to help the patient confront the possibility of death openly - an attitude that frees energy for living. People who are concerned with "false hope" often see themselves as realists, people who see life "as it really is." But a life view that does not include hope is not realism but pessimism. This stance may avoid disappointment, but it does so by actively shaping negative outcome. Hope is an important element in survival for the cancer patient. Indeed, as the studies indicated, hopelessness and helplessness ar frequent precursors of cancer. The hope we try to impart is essentially a stance toward life. It is not just a matter of philosophy, but of survival. For each patient, the process of getting well includes redefining his or her own stance toward the experience of a life-threatening disease so that there is hope. (p. 82)PARTICIPATING IN YOUR HEALTH: If you think back, you will probably see how many small ailments in your life, such as colds or headaches, occurred when you were tired, overworked, under tension or emotional stress. You have probably said many times that you caught a cold because you were "run down," and you most likely meant not just physical fatigue but also emotional depletion, a lack of vigor and enthusiasm. (p. 104) Serious ailments, too, such as heart attacks and ulcers, have been observed to follow periods of overwork, tension, pushing too hard. They tend to occur when the body has reached its upper limit and can carry no more, but the signals of this situation have been ignored. Anyone who has had an ulcer is aware of how it acts as a feedback device for emotional overload, an index of the "state of the organism," because pain from the ulcer is most likely to occur when one is tense or anxious. A physician friend says that in a way he regrets having had surgery for an ulcer because without the ulcer's reminder, he can't tell anymore when he is overly tense, and he worries about what other effects the tension might have on his body. All of us participate in becoming sick through a combination of mental, physical, and emotional factors. You many have been very tense or anxious for a long period of time without doing enough to relax. You may have maintained unreasonable work loads or gotten so caught up in meeting everyone else's needs that you ignored your own. You may have maintained attitudes and beliefs that prevented you from having satisfying emotional experiences. In sum, you have failed to recognize your physical and emotional limits. To the extent that you ignored these legitimate needs, you participated in your own illness. When the body's and mind's requirement for relaxation, rest, exercise, emotional expression, even for meaning in life are neglected, then the body may communicate this failure to pay attention by getting sick. (p. 105) It is not our intent, nor is it desirable, for you to feel guilty for having recognized that you've participated in your disease. There is a difference between being "to blame" for something and having "participated" in it. It makes no sense to blame persons living in his society for becoming ill in light of the rules they were taught for dealing with their emotions and feelings. (Few individuals in our culture have been taught how to deal with emotions appropriately.) Blame suggests a person consciously knew better and yet decided to respond or act in a self-damaging way. That is certainly not true of people who respond to stress by developing a physical illness. Like most people in our culture, you were probably not even aware of a link between emotional states and illness. Thus, the way in which you did participate are almost certain to have been a result of unconscious beliefs and habitual behavior. (p. 115) THE BENEFITS OF ILLNESS: In a culture where feelings are given little importance and emotional needs vital to a person's well-being are frequently ignored. disease can fulfill an important purpose: It can provide a way to meet the needs that a person has not found conscious ways of meaning Illness includes much pain and anguish, but also solves problems in people's life. It serves as a "permission giver" by allowing people to engage in behavior they would not normally engage in if they were well. Think for a moment of some of the things that people get when they are sick: increased love and attention, time away from work, reduced responsibility, lessened demands, and so on. Because cancer patients are often people who have put everyone else's needs first, they have obviously had difficulty permitting themselves these freedoms without the illness. In this way, illness works to suspend many of the attitudes that block people from paying attention to their own emotional needs. In face, when you are ill may be the only time it is acceptable to drop the responsibilities and pressures of your life and simply take care of yourself without guilt or the need to explain or justify. (p. 117) Several other patients have found that their disease temporarily removed them from an intolerable job. Again, because the disease only suspends the problem for them, it is important they they confront the personal attitudes and behaviors that permitted the situation to become intolerable in the first place - or they are likely to recreate the situation and the disease each time they return to work. Illness give patients temporary permission to act in more open ways emotionally. But if they cannot learn to give themselves that some permission when they are healthy, then the moment they get well the old rules again apply, and they find themselves in the psychologically and physically destructive situation that first contributed to their illness. (p. 120)The task that faces the patient includes: (1) identifying the needs being met through the illness, and (2) finding ways of meeting those needs directly without illness. (p. 121)RELAX AND VISUALIZE RECOVERY: The first step in getting well is to understand how your beliefs and emotional responses have contributed to your illness. The next step is to find ways of influencing those responses in in support of your treatment. In this chapter, we will tell you about a relaxation process for reducing the effect on your body of stress and tension associated with the onset of cancer and with the fear of the disease, which itself becomes a major source of stress. We will also show you how to use mental imagery, once your relaxed, to create positive beliefs that will activate your body's defense against disease. (p. 125) It is important to note that, in clinical terms, relaxation does not mean spending an evening in front of the television, having a few drinks, or talking to friends. Although these certainly can be pleasurable activities, laboratory studies show that such forms of "relaxation" do not result in an adequate discharge of the physical effects of stress.... Fortunately, researchers have developed a variety of simple relaxation techniques - certain forms of meditation and progressive relaxation, autogenic training and self-hypnosis. (p. 126) Relaxation and mental imagery are among the most valuable tools we have found to help people learn to believe in their ability to recover from cancer. In fact, we mark as the conception of our present approach the first time Carl used mental imagery with a patient. Since then, we have discovered that mental imagery is not only an effective motivational tool fro recovering health, but is also an important tool for self-discovery and for making creative change in other areas of life.(p. 129) The common thread running these disciplines was that people created mental images of desired events. By forming an image, a person makes a clear mental statement of what he or she wants to happen. And, by repeating the statement, he or she soon comes to expect that the desired event will indeed occur. As a result of this positive expectation, the person begins to act in ways consistent with achieving the desired result and, in reality, helps to bring it about. "self-fulfilling prophecy" (p. 130)VALUE OF RELAXATION AND MENTAL IMAGERY: (1) Decrease fear: Most fears comes from feeling out of control - in the case of cancer, feeling your body is deteriorating and you are powerless. Relaxation and mental imagery help you see your role in regaining health so that you begin to sense your own control. (2) The process can bring about attitude changes and strengthen the "will to live." (3) It can effect physical changes, enhancing the immune system and altering the course of a malignancy. Since mental processes have a direct influence on the immune system and hormonal balance in the body, physical changes can be directly attributed to changes in thought patterns. (4) The process can serve as a method for evaluating current beliefs and altering those beliefs, if desired. Alterations in the symbols and pictures that you can dynamically alter beliefs to those more compatible with health. (p. 137) (5) The process can be a tool for communication with the unconscious - where many of our beliefs are at least partially buried. (p. 137-138) (6) It can be a general tool for decreasing tension and stress. The process of regular relaxation by itself can decrease tension and stress and have a significant effect on underlying body functions. (7) The process can be used to confront and alter the stance of hopelessness ad helplessness. We have seen again and again how this underlying depression is a significant factor in the development of cancer. As people begin to picture their bodies regaining health, their ability to solve the problems that existed prior to the malignancy, they weaken their sense of helplessness and hopelessness. Indeed, as the patients proceed toward health, they gain a sense of confidence and optimism. (p. 138)OVERCOMING IMAGERY PROBLEMS: Some people are more visual than others; they think in images. Some people tend to sense things. Others feel things. Some think words. Because of these individual difference, we have found that when we use the word "see" in our instructions to the the mental imagery process, some people might instead "feel" what it is like to be well. When we say "See yourself becoming well," they might have the "sensation" of energy and health. It has become increasingly clear to us hat a person should stay with the process or way of thinking that he or she is most comfortable with, rather trying to become primarily visual. (p. 138-139) Another problem we have found to be very common during mental imagery is the tendency for a person's mind to wander. This often represents a lack of concentration which can be aggravated by certain medication, by pain, or fear. From time to time it is a problem that affects everyone using the process regularly. One of the most effective ways of dealing with distractions is to stop the process and ask yourself what is going on: "Why is my mind wandering?" Pursue that line of thought for a short time. Then focus back on the exercise and go through it with whatever degree of success you can attain. A third difficulty is the feeling that saying the cancer is "shrinking" is actually lying to yourself. We've heard statements such as, "I've got a cancer growing on my shoulder, I can feel it, it's not possible for me to see it shrinking when I know it's growing bigger." The problem her is a confusion about the purpose of the mental imagery process. We are attempting to help the patient visualize the desired outcome, not what may be happening at the time. It is possible to picture the cancer shrinking even when in reality it is growing; you ar picturing in your mind what you want to come about. Understand this distinction is very important. Mental imagery is not a method of self-deception; it is a method of self-direction. (p. 139)CRITERIA FOR EFFECTIVE IMAGERY: (1) The cancer cells are weak and confused. It is important to depict your cancer cells as anything soft that can be broken down, like hamburger meat or fish eggs. (2) The treatment is strong and powerful. The treatment is clearly capable of destroying the cancer. (3) The healthy cells have no difficulty repairing any slight damage the treatment might do. Since the treatment usually touches all cells, not just the cancerous cells, you should visualize your normal, healthy cells as being strong enough so that the treatment does little damage to them, and they are capable of repairing any minimal damage. The cancerous cell are destroyed by the treatment because they are weak and confused. (4) The army of white blood cells is vast and overwhelms the cancer cells. The white blood cells are a symbol of your body's natural healing process, so your imagery should reflect vast numbers of these cells and great strength. The victory of the white cells over the cancer should be seen as inevitable. (5) The white blood cells are aggressive, eager for battle, quick to seek out the cancer cells and destroy them. (p. 144) Visualize your white cells overwhelming the cancer cells, leaving no doubt about which cells are stronger. (6) The dead cancer cells are flushed from the body normally naturally. (7) By the end of the imagery, you are healthy and free of cancer. This image represents your desire for the final outcome; it is important that you see your body clearly as healthy, vital and energetic. (8) You see yourself reaching your goals in life, fulfilling your life's purpose.(p. 145) It is important to visualize your treatment as a friend and ally. (p. 147)OVERCOMING RESENTMENT: Processes that help people release resentment, express negative feelings, and forgive past wrong (whether real or imagined) may well be a major part of the preventive medicine of the future. And because cancer patients often have unresolved resentments, and other emotional ties to the past (as we have seen, perceived abandonment or rejection by one or both parents may be an antecedent to the development of cancer). helping our patients learn to release the past is often essential in helping them get well. Resentment is not the same as anger: Anger is generally a single, relatively short-lived emotion (one with which we are familiar) whereas resentment is a long-term restressing process. (p. 164) No matter how justified those feelings may have been when the experience first occurred, continuing to carry them has tremendous physical and emotional costs. If you are harboring such feelings, the first thing you must acknowledge is that you - not the other person - are the ultimate source of your own stress. (p. 165)MENTAL IMAGERY FOR OVERCOMING RESENTMENT: (1) Sit in a comfortable chair, feet flat on the floor, eye closed. (2) If you feel tense or distracted, use a relaxation process. (3) Create a clear picture in your mind of the person toward whom you feel resentment. (4) Picture good things happening to that person. See him or her receive love or attention or money, whatever you believe that person would see as good thing. (5) Be aware of your own reactions. If you have difficulty seeing good things happening to the person, it is a natural reaction. It will become easier with practice. (6) Think about the role you may have played in the stressful scene and how you might reinterpret the event and the other person's behavior. Imagine how the situation might look from the other person's point of view. (7) Be aware of how much more relaxed, less resentful you feel, Tell yourself you will carry this new understanding with you. (8) You are ready to open your eyes and resume your usual activities. (p. 167) Forgiving yourself is very important also. (p. 168) The resentment imagery process is not a way to avoid expressing true feelings by turning them into unnaturally positive images. Rather, it is a way to gain insight into your old hurts and relieve the damaging side effects. After using the process repeatedly, our patients have shown - both the subjective reports and objective psychological - less tendency to repress and deny their feelings. The become able to deal with their feelings more effectively, and as a results, experience less stress and tension. (p. 171) Since one does not simply turn negative feelings into positive feelings, it takes a great deal of effort to begin to visualize good things happening to a person toward whom you feel resentment. In the attempt, however, you began to confront your own role in reacting to the hurtful situation as you did. You may find, as have a number of our patients, that some of your resentment toward the other person may be because you yourself reacted in a way you didn't approve of, and you wish you had reacted differently. (p. 171-172) By allowing the energy tied up in resentment to be redirected toward constructive decisions, you will be much more closer to leading the kind of life you want to live. These gains will enhance your body's ability to eliminate cancer and dramatically improve the quality of your life. (p.172)BENEFITS OF SETTING GOALS: The most effective tool we have found for getting our patients to take specific, positive action is to ask them to set new life goals. By asking a person to set goals, we help them conceptualize and focus their reasons for living and will make an effort to achieve. It is a way to transform emotional, mental, and physical needs into a life-affirming behavior, to reinvest yourself in live. The will to live is stronger when there is something to live for. Setting goals has many other benefits for the cancer patient. (p.174) (1) Setting goals prepares you mentally and emotionally to act out your commitment to regain health. (2) Setting goals expresses confidence in your ability to meet your needs. (3) The stance that you are in charge of your life builds a positive self-image. (4) Setting goals provides a focus for your energy. It establishes priorities. We point out that the primary value of setting goals lies in being involved in your daily living and committed to worthwhile objectives, whether or not they are met. It is the process of striving to meet our goals, not their ultimate fulfillment, that give meaning to life. (p.175)SUGGESTION FOR GOAL SETTING: (1) Write balanced goals for what you want to do - including activities that provide personal meaning as well as pleasure. Include goals that address (1) your purpose in life: personal growth , your relationships with others, your career, and financial targets; (2) goals that are focused on pure recreation; and (3) Goals focused on physical exercise. (2) Make your goals concrete and specific. (p. 178) (3) Make your goals measurable. (4) Make your goals realistic. (5) Make your goals within your power to make happen. (p. 179) (6) Don't be afraid to dream. (p. 180)YOUR INNER GUIDE: The means by which the unconscious communicates with the conscious self is through feelings, dreams, and intuitions. Unfortunately, our culture seems to undervalue these messages. We are taught to value external events and objects - behavior, our bodies, material things, the logical output of our minds - but not our internal environment. Therefore, we tend to ignore feelings, dreams, and intuitions from our internal self, which are attempting to provide us with resources to meet the demands of the external world. One process for permitting this communication with the Inner Guide is called "guided daydreaming," a form of mental imagery. (p. 186) For many people, the Inner Guide takes the from of a respected authority figure - a wise old man or woman, a doctor, a religious figure - with whom the patient is able to carry on an internal conversation, asking questions and hearing answers that seem to be wise beyond the individual's conscious capacities. (p. 187)THE INNER GUIDE MENTAL IMAGERY PROCESS:(1) Sit in a comfortable chair, feet flat on the floor, eyes closed. Use a relaxation process. (2) In your mind's eye see yourself in a natural setting that gives you a feeling of warmth, comfort, peace, and serenity. Select the spot from your memory of your fantasies. Concentrate on the details of the scene. Try to experience it with all your senses - as if you were really there. (3) Notice a path emerging near you, which winds toward the horizon. Sense yourself walking along this path. It is pleasant and light. (p. 195) (4) Notice that in the distance there is a radiant blue-white glow, which is moving slowly toward you. There is nothing frightening about the experience. (5) As the glow comes closer, you realize it is a living creature - a person or a friendly animal. (6) As the person or creature comes closer, be aware of the details of its appearance. Is the creature masculine or feminine? See its shape and form as clearly as you can. If your guide is a person, notice details of face, hair, eyes, bone structure, build. (7) If this person or creature makes you feel warm, comfortable, and safe, you know it is an Inner Guide. (8) Ask the guide's name, and then ask for help with your problems. (9) Engage the person or creature in a conversation, get acquainted, discuss your problems as you would with a trusted friend. (10) Pay careful attention to any information you receive from your guide. It may come in the form of conversation through symbolic gestures, such as the guide's pointing toward something or producing an object that represents its advice. (11) Establish an agreement with your guide about how to make contact for future discussion. (12) Then when you are ready, let your consciousness come back slowly into the room where you are setting and open your eyes. (p. 196)

Paul Durbin: 6 Session Protocol for CancerAdapted from Simonton Model in Getting Well Again

FIRST SESSION: Counseling with client to get information concerning his/her cancer history, clients expectation, how counseling and hypnosis can help. Use first session pre-post protocol and explain the connection between stress and health. Ask the client the following and discuss response: 1) Does what you think have any effect upon your body? 2) Can the improper handling of stress cause illness in your body? 3) Can the proper use of your mind and spirit improve you health and well-being? To demonstrate the effect of the mind on the body, have client (if physical condition permits) stand up and put dominate arm and hand and resist as I push down and have client to think a happy thought. Now have the client think a sad thought and resist. (The difference is obvious.) It appears to me that if a sad though can cause one to lose power in his or her arm, it follows that day after day, week after week, month after month of sad and negative thinking can cause harm to one's body. The wise man of Proverbs realized the relationship of body, mind and spirit for he wrote, "A cheerful heart does good like a medicine but a broken spirit makes one sick." (Proverbs 17:22) Six major categories of potential harmful stress: 1) Death of a significant other: spouse, child, parent, relative, close friend or even a political or religious leader. 2) Marriage, separation, divorce, child being born, child leaving home, child returning home. 3) Business readjustment, financial change either up or down, losing a job, retirement. 4) Emotional and/or spiritual conflict 5) any significant change in one's lifestyle, moving, neighborhood changing, cost of living etc. 6) Daily problems and frustrations. I believe that each individual is a trinity within himself/herself. I am a trinity, you are a trinity. We humans are made up of a trinity of our own: "the human trinity." We are three-in-one: body (physical), mind (psychological/emotional, and spirit (spiritual). These three aspects of our being are so different and yet so integrated that one part of the human trinity cannot be affected without having some effect on the other two.

As early as 1950, Dr. Hans Selye of the University of Montreal was saying that anger and frustration, induced by stressful situation, increased the susceptibility to illness. During these stressful situations there is an increased output of hormones. These hormones quickly prepare the body to meet the emergency situation causing changes to take place and preparing the body for "flight or fight." When our caveman ancestors were faced with a threat, they fought it if they thought they could defeat it or they ran from it if they felt they could not win. In today's society, "fight or flight" are not always possible reactions to stress. For an illustration: If my boss fusses at me, I could say, "Take this job and shove it." but then I would be out of a job. I could even take another step and hit him, but then I would be out of a job and probably in jail. So instead of saying "take this job and shove it." or hitting my boss, I mask my feelings and with a smile say, "Yes sir, I will make sure that never happens again." When the hormones that are released into our bodies during stress are not properly discharged though action, they create an imbalance. Dr. Seyle states that this imbalance causes various kinds of damage including depression of the immune system which helps protect us against illness. Stress which is not recognized or improperly handled tends to reduce our natural immunity to disease. When not handling stress properly, we become more susceptible to disease. In his book Psychology, Religion and Healing, Leslie Weatherhead writes, "If an emotion is neither expressed in its appropriate action or even admitted to consciousness. It will have its revenge by setting up some form of mental or physical distress."

Carl Simonton and Arnold Hutschnecker would add cancer to the above list. Dr Hutschnecker wrote, "We are moving toward a recognition that in illness of any kind, from the common cold to cancer, emotional stress plays a part." Saying that we participate in the sate of our health is not intended to produce guilt for being sick, but to give hope toward health. Though we continue to rely on proper medical procedures, we can add our own hopeful expectation to stay healthy and to have an effect upon our healing process when sick or injured. The writer of Proverbs (23:7) put it this way, "Whatsoever a person thinketh in his heart, so is he." and (17:22) "A cheerful hart does good like a medicine, but a broken spirit makes one sick." If the improper handling of stress can cause us harm, what are some the things we can do to reduce the harmful effects of stress? 1) Exercise: Recall that your body often manifests the "flight or fight" response to stress. When one is faced by a threat: physically, emotionally or spiritually; the body prepares itself for a strenuous effort. Regular physical exercise helps you use the extra sugars and fats in your blood caused by stress. If you are angry, try to blow off stream physically by activities that are helpful to you. I like to walk a couple of miles a day which helps me to reduce stress. For others, it may be various sports, running, or just working at your hobby. Of course before beginning any strenuous activities, you should see your doctor to determine what is best for you. 2) Balance work and play: Schedule time for play. Learn to play and have a good time. Play is what you do for yourself. You may do it with other, but it what you do for your enjoyment. When my sons were young, they used to like to play Monopoly and so did I. There were times I would suggest that play and sometimes one of my boys would suggest that we play. That was play. At times I would come home tired and all I wanted to do was set in the easy chair and watch TV. When one of my son would suggest that we play Monopoly, I would join them in a game, but then it was not play. All work and no play can make you a nervous wreck. (Importance of laughter: Have client laugh for several minutes) 3) Learn to accept what you cannot change: To accept does not mean to like. It means to do the best you can under the circumstances. When disappointment or limitations come, it to say, "Now that my spouse has left me , how do I best live life with the one I love?" "Now that I have this disease, how do I best live life with this illness?" "Now that I have this limitation, how do I best live life with this limitation?" 4) Talk over your worries every one needs someone to talk to. Coming here today indicates that you are ready to talk to someone. 5) Avoid over self-medication: I am not talking about an occasional use of an aspirin or Preparation H, but the need for drugs or alcohol to get through the day or night. Although there are many chemicals such as alcohol or drugs which can mask your symptoms, they do not help you adjust to stress. 6) Get enough sleep and rest: The amount of sleep will differ from person to person, but a lack of the proper amount of sleep will reduce your ability to deal with stress. 7) Prayer and meditation: I believe to be the whole person that our creator meant for us to be, we must develop the spiritual side of our being as well as the emotional and physical. An airplane doesn't cease to be an airplane when it sets in the hanger or takes off along the runway, but its true nature becomes apparent only when it is airborne. Similarly, a person is a human being even when he or she is functioning only on the physical and psychological planes, but one shows his or her essential humanness when he rises to the spiritual dimension. A man asked his three daughters how much they loved him. The oldest of them replied that she loved him more than all the gold and silver in the world. The father was noticeably pleased with her answer, through his arm around her and thanked her. The second daughter responded, "I love you more that the most valuable jewels in the world." The father was pleased with her response so through his aims around her and thanked her. The third and youngest daughter said, "I love you better than salt." The man was not especially elated with her remark and dismissed it lightly as an indication of her immaturity. Nevertheless, he put his arms around her and thank her. His wife, their mother, overhearing the conversation, left salt out of her husband's next meal. As he ate, he was thus confronted with the deep meaning of his youngest daughter's remark. She was saying that he was the flavoring and spice of her life. Developing the spiritual aspect is the life what salt is to food. The spiritual dimension gives flavor and seasoning to life. When one is functioning on all levels (physical, emotional and spiritual), life is more productive and more healthy. 8) Learn to relax and use your and use your mind to help you deal with stress: The use of relaxation and self-hypnosis is available to each of us and is very easy to learn and use. For self-hypnosis to work for you, you must believe it will work, expect it to work, visualize and or imagining it working and practice it. When beginning relaxation and self-hypnosis: 1) Select a place where you can be reasonably sure that you will not be disturbed by unnecessary noises or interruptions; dark or subdued light and soft music may be helpful for relaxation and self-hypnosis. 2) Lie down on a bed or sit in a comfortable chair. Allow the arms to lie beside you on on the arms of the chair of upon your thighs. Do not interlock fingers for that might cut off circulation. Best not to cross legs. Remove hard contact lenses. 3) make a tight fist then let hand relax slowly. Let mind register changes from tension to relaxation so that the mind has a model for relaxing the rest of the body. 4) At my direction, take three deep breaths. This can be a trigger mechanism for going into the hypnotic state. Take three deep breaths at my directions. Breath in relaxation, exhale tension. Breath in relaxation, exhale tension. Breath in relaxation, exhale tension. 5) Count to yourself 1, 2, 3, 4, 5 and say deeper and deeper. This is your trigger mechanism for going quickly, soundly deeply into the hypnotic state. I pointed that there are four things that contributes to one's ability to obtain pain relief with self-hypnosis: (1) your success in developing a self-hypnotic trance; (2) your motivation to get pain relief; (3) proper handling of your fears of letting go of the pain; (4) understanding that you have some control over your pain. In addition, (1) Success with self-hypnosis techniques is a matter of practice. You will need to experiment with various approaches, suggestions and kinds of imagery. Relaxation in many cases will relieve a considerable amount of pain. Muscle tension often puts pressure on nerves; this aggravates discomfort. Easing your tension is the first goal. Then you can begin dealing directly with the pain. (2) Motivation for pain relief means freeing yourself from the need to keep pain in your life. It may seem unbelievable you might "need" to keep pain. But often there are advantages as-well-as disadvantages to pain problems. If pain results in you getting secondary gains and getting out of responsibilities you do not like, these benefits can reduce your motivation to feel better. (3) You may fear letting go of your pain. Because we know that pain can be a signal of something wrong inside us, we may fear shutting it off. (4) You can have some control over your pain. Pain serves our survival needs and we have the some control over it. Progressive Relaxation and Deepening:STRESS REDUCTION "CALM AND RELAXED:" Script can be found under "Pain Management and Enhancing Healing Protocol: SELF CONFIDENCE AND EXPECTATION OF IMPROVEMENT:Homework for next session. Have client make a list of stressful experiences or crisis situations in his/her life that occurred in the six months to a year and a half in the life of the client. I may go to "Pain Management and Enhancing Healing" protocol for more scripts for reducing pain if needed.

SECOND SESSION: Go over the client's list of stressful experiences or crisis situations in the past six months to a year and a half in the life of the client. Discuss the importance of imagery on improving health and enhancing healing.If appropriate for the session: SUBCONSCIOUS QUESTIONS FOR CANCER PATIENTS: (Using ideomotor response finger response of pendulum) 1. ARE THERE ANY EMOTIONAL PROBLEMS CONTRIBUTING TO DISEASE? 2. HAVE YOU GONE THROUGH SOME EXPERIENCE IN THE PAST THAT CONTRIBUTES TO THIS DISEASE? 3. ARE YOU IDENTIFYING WITH SOMEONE ELSE, PERHAPS A PARENT OR SIGNIFICANT OTHER WHO HAD CANCER? 4. DO YOU USE THIS DISEASE AS A MEANS TO PUNISH YOURSELF? 5. ARE YOU USING THIS DISEASE AS A MEANS TO PUNISH SOMEONE ELSE? 6. IS THERE SOME CONFLICT CONCERNING SEX THAT CONTRIBUTES THIS DISEASE? 7. DO YOU HAVE THIS DISEASE BECAUSE YOU FELL GUILTY ABOUT SOMETHING? 8. DO YOU EXPERIENCE THE SYMPTOMS OF THIS DISEASE MORE WHEN YOU ARE LONELY? 9. DO YOU EXPERIENCE THE SYMPTOMS OF THIS DISEASE MORE WHEN YOU FEEL STRESS OR TENSION? 10. DO YOU EXPERIENCE THE SYMPTOMS OF THIS DISEASE MORE WHEN YOU ARE ANGRY? 11. DO YOU EXPERIENCE USE THIS DISEASE AS A MEANS OF DRAWING ATTENTION DRAWING ATTENTION TO YOURSELF? 12. IS THERE ANY SUBCONSCIOUS REASON YOU NEED TO CONTINUE WITH THIS DISEASE? (IF ANSWER IS "YES" ASK, "CAN YOU, OR DO YOU WANT TO DISCUSS WHY YOU NEED TO CONTINUE?) 12. IS IT OK WITH YOUR SUBCONSCIOUS MIND FOR YOU TO BE HEALED OR TO REDUCE THE SYMPTOMS OR TO ELIMINATE THE SYMPTOMS OF THIS DISEASE? * IF ANSWER IS "NO" ASK, "CAN YOU, OR DO YOU WANT TO DISCUSS WHY YOU DO NOT WANT TO GET RID OF SOME OR ALL OF THE PAIN?"** IF NO RESOLUTION GOT TO "THERAPY BETWEEN SESSIONS?"SCRIPTS FOR SECOND SESSION: DEVELOPING ANESTHESIA AS FORGETTING SHOES ON FEET, ETC.: (Script found in "Pain Management and Enhancing Healing Protocol) GLOVE ANESTHESIA: (Script found in "Pain Management and Enhancing Healing Protocol") THE SETTING SUN PAIN METAPHOR: (Script found in "Pain Management and Enhancing Healing Protocol") (If client is a Christian and religious use): THE HEALING TOUCH OF JESUS: (Script found in "Pain Management and Enhancing Healing Protocol") RESTORING HEALTH: ELIMINATING CANCER:Discuss with client the benefits of illness (secondary gains) and for homework have client list benefits he/she gets from his/her illness.

THIRD SESSION: Discuss the benefits that clients receives from his/her illness and help discover ways to meet those need without the illness. Go over importance of imagery and positive or hopeful expectation. If not already known, discover if client is having difficulty with chemotherapy. If client is experiencing any anger or resentment discuss that and help client release. Imagery that will help: 1. Increase the number of health white blood cells. (See the number of white blood cells increasing and see the cancer cells as weak and disorganized cells that they, in truth are.) 2. Increase number of natural T killer cells and T helper cells. (Both T killer cells and T helper cells are destructive to cancer cells.) 3. Increase the power of any cancer fighting medication or radiation by imaging them as allies in the battle to defeat the cancer and bring healing. (See your chemotherapy/radiation killing cancer cells but not destroying healthy cells.) 4. Increase activity of bone marrow-producing healthy cells 5. Imagine the cancer cells decreasing and gone. the blood flowing freely with out stress or tension to bring healing and health. 6. Imagine that you are healed and doing the thing you want to do and enjoying life.REDUCING THE SIDE EFFECTS OF CHEMO-THERAPY: Cancer patients often get very nauseated by just the thought of chemo-therapy or when they come into the hospital or treatment room for chemo-therapy. You can reduce the effects of chemotherapy if you consciously do five things: 1. Believe your treatment is a healing agent. A. Make it your friend. B. See it as a healing agent. C. Imagine it sweeping your body clean and removing the cancer cells. 2. Relax before, during and after treatments. A. Learning to relax is another key to reducing side effects. B. If you are calm, you'll find it much easier to go through your treatments. C. Make relaxation tapes or have a tape recorded while in therapy to listen to during treatment. 3. Visualize healing imagery. A. Imagine telling a friend, "I was so peaceful during Chemo." or "Each treatment is easier." B. During treatment, imagine it healing you. C. Draw a picture of how the treatment is destroying the cancer and bringing you healing. D. By visualizing this drawing, youâ€™ll crate an optimistic attitude which is one of the most important factors influencing how you experience Chemo. 4. Release repressed emotions. A. Often cancer patients have unresolved emotional problems that need to be considered and released. B. Some of these emotions suppress the immune system. (If not already demonstrated, have volunteers come forward for arm strong, arm weak depending on a happy/sad thought. C. If you have had a diagnosis of cancer, use it as a wake-up call. 5. Create or find a positive support group. A. Find a support that uplifts you B. Select a group that is caring, informative and enhances the life of its members. The effects of beliefs concerning chemotherapy: 1. Do you welcome it - or fear it? 2. Will it cleanse your body of all cancer cells? 3. Is it healing or toxic? 4. Do you really want it - of just following doctor's advice? What you think really does make a difference. The World Journal of Surgery reported that of a control group, 30% lost their hair just because they thought they had received chemo-theapy. In fact, they had a placebo, a harmless substance. (Peggy Huddleston, Prepare for Surgery, Heal Faster:) I have found that relaxation, imagery and hypnosis are important assets in the reduction of the side effects of chemo-therapy. I have the client visualize their white blood cells joining with the chemo-therapy to destroy any enemies to their health. This is done in such a way to help the patient see their chemo-therapy as their friend with their own white cells destroying the cancer and bringing healing to their body.If client is experiencing nausea, I have them visualize the stomach containing a reddish fluid. I have them visualize the reddish fluid slowly turning to a clear fluid. I say, "As the color changes, you are feeling more and more comfortable. All discomfort is leaving as the fluid becomes clear. You are feeling more and more comfortable." I repeat this several times. I have the client visualize coming into the hospital or treatment clinic, going through the admit procedures, sitting down in their room, and taking the chemo-therapy without any discomfort. I have them visualize themselves relating to the nurses and hospital staff in a friendly and easy manner. I have them repeat to themselves several times, "I go through my chemo-therapy feeling good and comfortable." I have them seeing themselves well, feeling good, and being active. In their suggestion and visualization, I emphasize that they use suggestions and visualizations of what they desire to be in the present tense. That may seem unusual because we are accustomed to speaking of the future in the future tense, but the subconscious mind response much better to suggestion in the present tense as if it has already happened. I teach the client self hypnosis so that they can visualize this between treatments. I recommend that they use visualization at least once a day. OTHER SCRIPTS THAT MAY BE USED: OVERCOME CANCER: WATERFALL FOR CLEANSING AND RELEASING: (If needed to let go of anger, resentment and other negative emotions.) [Go to Visualization for Waterfall script]Home work: Make a list of goals to accomplish. Goals are important to maintaining a high quality of life. The good things about goals is that the client can list several goal as goals are meet, new goals can be added to the list. The will to live is certainly strengthened by setting goals.

FORTH SESSION: Discuss the goals that clients list.I encourage the client to laugh: I encouraged client to find material such as movies, TV programs books that would make her laugh. Laughter can be an important agent in the healing process. In Emmanuel's Book, the following advice is given, "Celebrate your life. Bring pleasure into it whenever you can and see that pleasure as truth not a some secret sin. When you begin to blossom and glow and dance down the street just because your are happy... then you are free." H. L. Mencken wrote, "Human life is basically a comedy. Even its tragedies often seem comic to the spectator and not infrequently they actually have comic touches to the victim. Happiness probably consist largely in the capacity to detect and relish them. Clifford Kuhn, M.D., a professor at the University of Louisville School of Medicine, believes that humor helps achieve one's full humanity. He said, "Humor is not just a series of joke - of strategies to make people laugh." With a twinkle in his eyes, he continues, "When humor is used to share ourselves with the essence of another, it is enormously healing. It is another model of therapy - an art." One may wonder, "How can laughter help someone with a terminal disease?" Dr. William Fry, Jr. has found that humor and laughter reduces several risk factors for heart disease. Laughter diminishes the physical tension which contributes to stress and is a part of the web of casualty for coronary. Laughter reduces the impulses of hostility and anger. He advocates that laughter for cancer patients reduces pain, mental anguish and depression which often accompanies the diagnosis of cancer.Many are familiar with Norman Cousins use of laughter to deal with the pain and debilitation caused by ankylosing spondylitis. Before Cousin no one had ever been cured of that disease. He was cured and lived to be in his 80's before dying of a heart attack. In his book the Anatomy of an Illness, he indicates that the body's own endorphins are much more effective than morphine without the side effects of morphine. Laughter like relaxation is effective in reducing the experience of pain and reducing the harmful effects of stress. Norman Cousins, the editor of the Saturday Review used humor to help him recover from a life-threatening and crippling disease. Cousins came to the conclusion that if negative thinking could produce negative reaction in his body, then positive thoughts could bring positive response in his body. He watched tapes of comedy shows and laughed a lot. Cousins discovered that ten minutes of heavy laughter produced an aesthetic effect for him that lasted up to two hours. It has been discovered that hearty laughter increases the levels of endorphins and enkephalins in the brain which is the body's own pain killer. Both laughter and play exercises the lungs, simulate the circulatory system, and increases oxygen to the blood. Norman Cousins called laughter "a from of internal jogging." (Have client laugh out loud for a short time.) Laughter and play increases the endorphins, decreases anxiety and depression and activates the Thymus gland and generally increases the immune system activity. Viktor Frankl speaks of humor as one of the souls weapons in the fight for self-preservation and health. "It is well known that humor, more than anything else in human makeup, can afford an aloofness and an ability to rise above any situation, even if only a few seconds." [Frankl, p68] The fact that these words were written by Frankl while he was in World War II concentration camp adds to their validity.THE QUESTION OF "FALSE HOPE": Sometimes I am asked, "Aren't you giving your clients/patients false hope?" My answer is "No," I am giving them reasonable hope. My approach does not guarantee recovery. But the question of "false hope" suggest that people should never have hope if there is a good chance they will be disappointed. Such a belief provides no basis for living a full life or for dealing with a threat to life. People without hope do die. Patients who have worked hard using my approach have still died, although in many cases they have significantly outlived their prognoses - and lived a more rewarding life than they would have had they not actively participated in their treatment. We live in bodies that will someday die. That is a fact of life. I include therapy designed to help the patient confront the possibility of death openly - an attitude that frees energy for living. People who are concerned with "false hope" often see themselves as realists, people who see life "as it really is." But a life view that does not include hope is not realism but pessimism. This stance may avoid disappointment, but it does so by actively shaping negative outcome. Hope is an important element in survival for the cancer patient. Indeed, as the studies indicated, hopelessness and helplessness are frequent precursors of cancer. The hope we try to impart is essentially a stance toward life. It is not just a matter of philosophy, but of survival. For each patient, the process of getting well includes redefining his or her own stance toward the experience of a life-threatening disease so that there is hope. While she was in the hypnotic state, I said, "Allow yourself to become very comfortable. Let any fear fade away...Begin your healing journey by letting go of the worries and concerned of the day. Your immune system is releasing stronger and more effective cancer fighting chemicals and pain reducing chemicals into your blood stream. You have a strong ally in your chemotherapy helping you fight any diseased cells. Your faith is provide you with inner peace and comfort. David wrote in the Psalms (46:11) 'Be still and know that I am God.' That is what you are doing now...You are learning to be still... Allowing your body to relax and tap into the powerful resources of your subconscious mind... You are aware of the inflow and outflow of God's love... You are in the process of making some very important changes that bring you greater happiness, joy and inner peace. You keep your thoughts positive and you find that attracts happy, healthy conditions to you... You meet the challenges in your life with confidence, sureness and power. Miracles come quietly into the mind that can be still... Healing: mental, physical, emotional and spiritual comes from within through the presence of God...You are being strengthened and rejuvenated by the Divine healing power of love.... Say to yourself now and many times each day, both in and out of the hypnotic state, 'Day by day in every way, I am getting better and better, healthier and healthier, and happier and happier."THE INNER GUIDE: The use of the inner guide in hypnotherapy is another means of communicating with the subconscious. It is also possible that the inner guide may be God's use of the Holy Spirit to guide one toward proper decision making and healing. The Bible often speaks of "angels" or as the word is sometimes translated "messenger" speaking, guiding, and healing. In the fourth chapter of Zachariah, we read "Then the angel who was speaking with me returned, (In the first chapter, the angel interpreted a vision for Zachariah) and roused me as a man who is awakened from his sleep." The angel speaks to Zachariah and again interprets a vision. While he was asleep, an angel told Joseph to marry Mary (Matthew 1). An angel appears to Peter as if in a vision to give him direction (Acts 12). St. John in the Book of Revelations begins "The Revelation of Jesus Christ, which God gave him to show to his bond-servant, the things that must shortly take place; and He sent and communicated it by His angle to His bond-servant John [Revelation 11:1]. An illustration of the inner guide as communicated with one's subconscious can be found in the Genesis story of Jacob's wrestling match with an angel. If the client is a religious person, I usually tell them the following story before using the "Inner Guide" theory. With or without a formal induction, I tell this story (depending on the situation, the story can be shortened): One of my wife's favorite T.V. program is professional wrestling. A few years ago, weekly wrestling program come on Saturday at 4:00 p.m., Bobbie took over the T.V. to see her favorite grapplers go after their opponents. If I was watching a football, basketball or baseball game, I had to either watch wrestling or go to the another room to watch T.V. For that hour, Bobbie had priority on the den T.V. Today, she has even more wrestling to watch with both the WCW and WWF having programs several nights a week. Apparently, she is not by herself, because wrestling is one of the most watched programs on T.V. I admit that I also enjoy watching the wrestling matches Most of us are familiar with the Randy "Macho Man" Savage, Hulk Hogan, Rick Flair, Sting, Stone Cold Austin, Goldberg, etc. Wrestling is not a new sport. It has been around for centuries. One of the earlier recorded wrestling matches was between Jacob and an angel, as recorded in the Old Testament Book of Genesis. You may be wondering to yourself, "Well, Chaplain, that is an interesting and unusual story, but what value does that wrestling match between Jacob and the angel have to do with me?" If that is what you are thinking, it is a good question. It is true that the story has great meaning in the history of the Jewish people, but does it have anything to say about you, to your life experience, and/or your struggle to live as a meaningful and worthwhile human being? [Genesis 32] If you can use your imagination just a little, you can receive a great personal message from this wrestling match. Every person has periods when he or she have had a struggle with their own inner self about some critical decision that they had to make. There have been times and there will be times in the future when one must wrestle with their own thoughts. Therefore, if you can see this as a wrestling match between a person and his thoughts, this story can speak to your situation in life in a very contemporary way. Have you every awakened in the night with a thought nagging you until sleep was impossible? How often have you struggled with some decision to be made or a guilty feeling over some wrong done, or some hurtful word spoken to another, or a helpful act left undone? The story of Jacob's wrestling match with the Angel is the timeless story about making decisions, of choosing between the good and bad, the best or something less. During Old Testament times, a person's name was an indication of his character. The name "Jacob" comes from a Hebrew word meaning "a heel". Jacob was a twin and when the time came for his mother to deliver the elder twin Esau, Jacob was holding onto his brother's heel. The symbolism of this is seen in Jacob's endeavor to hold Esau back and secure first place for himself. Because of this fact, the second child was called Jacob, or "one who takes by the heel" or "one who endeavors to trip up or take the position of another." It also reminds one of an American slang expression which describes an unethical person as a "heel". I am reminded of my tour with the Army in Thailand. In Thailand, there is a special significance to the foot in Thai thinking. It is impolite and downright insulting to point one's foot at another person. To point one's foot at another is considered insulting and vulgar. It is against the law in Thailand to step on money because a picture of the king is on the money and it would indicate that one is insulting the king and has no respect for the nation. Since the heel is the lowest part of the human body, a person who is a heel is the lowest form of human life. Jacob was a heel until that moment of self understanding in an all night wrestling match with an angel at the river Jabbok. Prior to that event, Jacob's life story was one event of deceit followed by another. These acts of deceit are first seen in Jacob's relationship with his brother and his father. One day, Jacob was cooking one of his favorite dishes when Esau cam in from a hunting trip. As it had been a long hunt and Esau had been without food for a long time, he was naturally hungry. Esau said, "Let me eat some of that good smelling pottage, for I am starving." Jacob saw his change to supplant his older brother and so replied, "Give me your birthright and you can have a bowl of this great tasting pottage." The birthright belonged to the oldest son and gave to that son the right to succeed to rank or title of the father and claim twice the property of any other child. Esau was more concerned with his stomach than his birthright and so he sold Jacob his birthright for a mere bowl of pottage. Following that conquest, Jacob tricked his aging and sightless father into giving him the father's blessing instead of Esau. By taking advantage of his father and by cheating his brother, Jacob secured advantages for himself. He treated other people as things to be used for his own advantage rather than relating to them as persons. However, as Jacob used other people as things, he found himself being used by his father-in-law, who deceived him. Even with that deception, Jacob ended up besting his father-in-law and left with the best sheep as he returned to his homeland. As he returned home, he was rich and successful, but feared what his brother might do to him when they met. On the way home, he stopped by a river called "Jabbok". He sent some of his best sheep to Esau as a peace offering. Having sent everybody on ahead, he spent the night by himself and the most important event of his life took place. He wrestled with an angel all night.

Jacob could not undo what had been done, but he could do something about his attitude toward himself and others. Jacob decided to wrestle with his attitude toward life until he had an answer. During this all night encounter by the river, Jacob was able to change his attitude about life, himself, others and God. Jacob had been a cheat and a heel and it appeared that he would remain one until he had the personal experience with God which changed his life. As a result of that life changing experience, his name was changed to "Israel" which means "with God". Our life situation and history may be vastly different from that of Jacob, but like Jacob, we can wrestle with our conscious and come from that wrestling match a new person. As we wrestle, we too can ask for a blessing and having received the blessing, accept the blessing and live the blessing. To introduce the client to his inner guide, I may use a guided image such as a walk in the country, lying down by a stream, and in the distance see a figure coming toward you. Just let the figure be whoever it will be. The guide is friendly, loving, caring and wants to help you live the best you can. You can ask the inner guide for insights to your problem (sickness, inferiority, lack of self confidence, failure cycle, fear, anxiety, etc.). There is nothing threatening about your experience for in fact it is a very pleasant experience. Discuss your problem with the inner guide as you would with a close friend. Pay attention to any information your guide shares with you. It is possible that the information may be symbolic, so remember everything. When you have completed your conversation, establish an agreement with your guide for future conversations. If at first you have trouble communicating with your inner guide, do not get discouraged. Though this inner guide is part of you, you are not accustomed to communicating with your inner self. By practice you can establish communication which will be beneficial to you. If you are uncomfortable consulting your inner guide, remember that it is your subconscious mind, your inner self which is that intuitive, wise, responsive part of you which you seldom communication with, but which is there to help you. If you can establish a meaningful relationship with your inner guide, you may receive important information and advice about your feelings, motivation, and behavior. The guide may let you know what caused the problem, illness, fear, and what you can do to help improve yourself.HYPNOTIC SUGGESTIONS WITH CANCER: (A cancer cell is a weak and confused cell. If it reproduces rapidly it may form a tumor. Normally cancer cells are quickly destroyed by the immune system. Recent research is demonstrating that imagery can assist immune system functioning. It is important for patients to communicate to the clinician their spontaneous imagery to the suggestions. This is important in terms of prognosis and also to help illuminate healing psychotherapeutic work that may be needed.) Allow yourself to become very warm and comfortable. Let any fear fade away...becoming very warm and relaxed...safe and secure. Begin your healing journey by first making yourself very small, as small as a drop of water, and then slip inside a clear bubble that protects you and supply you with everything you need. Allow yourself to become even smaller now and enter your bloodstream. Circulate through your body and tell your immune system to release stronger and more effective white blood cells into your bloodstream. Let these white blood cells be represented by an animated or symbolic form. Watch them stream through your bloodstream, full of energy and sure of their purpose...to dissolve any unhealthy growth that they find. If you would like you can transmit messages of encouragement or directions to your immune system...You might want to thank your immune system for the good job it is doing in the face of a challenger...or ask your immune system if there is anything you can do to help speed your healing. From a safe vantage point, see any tumors being dissolved as your white blood cells surround and overcome any unhealthy growth. See the area being completely healed and then watch your immune system cells patrol through your body in a loving and protective way. See and feel yourself being restored to a state of ideal health and appreciate and love yourself for taking the time to love and heal in this way. Counseling as needed and conclusion of session.

FIFTH SESSION: Counseling and encouragement. Discuss with client any spiritual, religious or emotional concerns. Discuss any fears that client may have to include the fear of dying. If needed, help client deal with preparatory grief. Work with client in areas that are of concern to the client.SCRIPTS FOR FIFTH SESSION: BREATHING FOR PAIN REDUCTION SCRIPT: PROTECTIVE ANTS. Go to "Pain Control and Healing" HEALING IMAGERY: Counseling and conclude session.

SIXTH SESSION: Overall review and focus on clients needs. SOME SCRIPTS THAT MAY BE USED FOR SIXTH SESSION: INDUCTION OF CHOICE HEALING THE WOUNDED PAST LIGHT HEALING IMAGE

HEALING FROM WITHIN (Adapted from Realization by Louis Bauer): As you continue relaxing now, you can feel that relaxation spreading throughout your entire body. You can feel that total relaxation from the top of your head to the bottom of your feet, and you can see it... As a soft gentle soothing protective blue light...gently surrounding you...protecting you...comforting you...and with that gentle loving light, comes peace... Recorded in the Bible, Psalms 46, verse 11, "Be still and know that I am God."...and that is what you are doing here today...You are learning to be still... Allowing your body and your conscious mind to relax through hypnosis enables you to tap into the powerful source of your sub-conscious mind. Jesus said, "The Kingdom of God is within you."...You have within you the answer to all the questions...the solution to all the problems...and the healing energies within you to heal any kind of illness, sickness or disease... As you continue relaxing now, your mind is at peace and is open to the awareness of the inflow and outflow of God... You are in the process of making some very important changes that brings you greater happiness, joy and inner peace... You really enjoy responding to everything I tell you and be pleased with the continuous improvements in all areas of your life... You meet every challenge in your life with confidence, sureness, and power... You keep your thoughts positive...and you find that attracts happy, positive conditions to you.. Miracles come quietly into the mind that can be still. Healing - mental, physical, emotional and spiritual - comes from within...You must accept guidance from within... Sit quietly with your eyes closed...The Light within you is sufficient...It alone has the power to heal... The Shining Peace within you is the perfect purity in which you were created... Look upon the lovely truth in you...Look to the holy place where you see The Light...shining purely, untouched and loving...so brightly within you. Jesus also said, "Let your light shine before men."... The Light within you awakens it in all...The Light that joins you, shines throughout the universe...and because it joins you, so it makes you one with the Creator... In each of us is a spark of the divine... Now as you relax even more, you are experiencing a wonderful feeling of well-being all through your body... You are pleased to find yourself experiencing many wonderful benefits by allowing yourself to be more calm and relaxed... You keep developing a greater attitude of love and understanding...Your spiritual awareness keeps increasing... The right path to take...and the right decision to make keep becoming clearer and easier to understand. Your self-confidence, self-acceptance, self-esteem and self-awareness keep increasing more and more each day... Everything I am saying is going into the storehouse of your subconscious mind...and your subconscious mind is responding by causing you to put my words into your own actions... And you notice all of the improvements - mentally, emotionally, physically and spiritually... Each day you become more determined to put your talents and abilities into action...You realize that you are learning to be successful. You do not need to measure up to anyone else's expectations...You are not here for the purpose of being what someone else expects you to be... Your belief - your subconscious belief, your subconscious knowledge is what really counts.. You have all the information needed in the storehouse of your mind to resolve any problem...and it is available any time you need it... Just be still... Your mind can sort out all of those secrets, feelings, imprints, impressions, thoughts and ideas...including those you may not be consciously aware of... And they can be examined in your own mind and in your own way...because your own mind has a very pleasant way of solving problems... It is a nice thing to learn, because it enables you to do the right thing - at the right time - and in the right way...and that is what's important right now... So continue relaxing peacefully and calmly.. You are a very wonderful and caring person... If everyone in the world were just like you, it would be a beautiful place to live... You are very special...very unique...one of a kind... God made you - body, mind and spirit - and He made you with love... You know now that you are a special person... God made you in His Image and God said, "(name), I give you a magnificent world to live in...use it, enjoy it, discover, learn, and become the person I made you to be"... God loves you...and God wants you to love yourself... First, you need to love yourself...and you are learning how to do this by leaving yourself and all that concerns you in the love and care of God... And you are realizing that what you cannot do...God can do... You are being strengthened and rejuvenated by a Divine Healing Power of Love. [Dr. Bauer's website: http://goodtapes.com/Hypnosis-Certification.htmIF NEEDED FOR POWERFUL RELEASING CONSCIOUS AND SUBCONSCIOUS CONTRIBUTIONS TO CANCER USE "HAND TO FACE FOR THERAPY" AND IF HAND DOES NOT TOUCH FACE GO TO "THERAPY BETWEEN SESSIONS" Counseling and conclude session, letting the client know that they can have future appointment as needed. ADDITIONAL SCRIPTS FOR CHRISTIANS: SELF-INDUCED (HYPNOTIC) DEEP MUSCLE RELAXATION SCRIPT FOR CHRISTIANS: Go to Joseph L. Hess "Christian Relaxation Technique"